Advocate Report Back Form
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Thank you for taking action!
As an advocate, you have done the hard work - now, let us know how it went! We will use the information you provide in our follow-up interactions with you and your legislators.
. Please provide your name:
Please provide your name:
. Today's Date
Today's Date Please complete: Month
. Date action was taken:
Date action was taken: Please complete: Month
. How did you take action? (please select one)
How did you take action? (please select one)
Called Washington D.C. Office
Called District Office
Sent an email to contact in Washington D.C. Office
Sent an email via webform
Visited the Washington D.C. Office
Visited the District Office
Attended a Town Hall Meeting
Referred to my legislator on Social Media
Other (please specify)
. Was the action in response to an ACHA Advocacy Alert?
Was the action in response to an ACHA Advocacy Alert?
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